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Latest & greatest articles for traumatic brain injury
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Optic nerve sheath diameter measurement for predicting raised intracranial pressure in adult patients with severe traumaticbraininjury: A meta-analysis. To evaluate and compare the diagnostic feasibility of measuring the optic nerve sheath diameter (ONSD), via brain computed tomography (CT) and ocular ultrasonography (US) for prediction of raised intracranial pressure (ICP) in severe traumaticbraininjury (TBI) patients.The PubMed and EMBASE databases were searched for studies assessing (...) the diagnostic accuracy of brain CT or ocular US for predicting raised ICP. Bivariate and hierarchical summary receiver operating characteristic modeling were performed to evaluate and compare the diagnostic feasibility of measuring the ONSD in adult patients with severe TBI according to modality (ocular US vs. brain CT).Five studies (four with ocular US and one with brain CT) were included. The ONSD had a pooled sensitivity of 0.91, pooled specificity of 0.77, and area under the HSROC curve of 0.92
Pharmacotherapy Effectiveness in Treating Depression After TraumaticBrainInjury: A Meta-Analysis. Depression is a highly prevalent neuropsychiatric sequela among individuals who have experienced traumaticbraininjury (TBI). Despite its high prevalence, there continues to be conflicting evidence surrounding the efficacy of medication for treating depression post-TBI and whether different treatments have distinct effects. The aim of this study was to systematically review and synthesize
S100B Serum Level as a Mortality Predictor for TraumaticBrainInjury: A Meta-Analysis. The pathogenesis of inflammatory neuronal cell damage will continue after traumaticbraininjury in which contributed to subsequent mortality. Serum S100B levels were shown to be an early predictor of mortality due to traumaticbrain injury.This Meta-Analysis will analyse the mean and diagnostic strength of serum S100B levels between survived and died subjects with head injuries based on the various follow (...) -up times of nine studies.We conducted a meta-anelysis in accordance with PRISMA guidelines and adhering to Cochrane Handbook for Systematic Review of Interventions. Literature search was conducted on March 16, 2018 from Medline and Scopus in the past 10 years, using various keywords related to S100, braininjury, and outcome. Duplicate journals were sorted out via EndNote. Included articles were as follows: original data from the group, clinical trials, case series, patients undergoing serum
Early Tracheostomy in Severe TraumaticBrainInjury Patients: A Meta-Analysis and Comparison With Late Tracheostomy. To elucidate the impact of early tracheostomy on hospitalization outcomes in patients with traumaticbrain injury.Lilacs, PubMed, and Cochrane databases were searched. The close-out date was August 8, 2018.Studies written in English, French, Spanish, or Portuguese with traumaticbraininjury as the base trauma, clearly formulated question, patient's admission assessment, minimum (...) ventilation duration (-4.15 [95% CI, -6.30 to -1.99]) as well as ICU (-5.87 d [95% CI, -8.74 to -3.00 d]) and hospital (-6.68 d [95% CI, -8.03 to -5.32 d]) stay durations when compared with late tracheostomy. Early tracheostomy presented less risk difference for ventilator-associated pneumonia (risk difference, 0.78; 95% CI, 0.70-0.88). No statistical difference in mortality was found between the groups.The findings from this meta-analysis suggest that early tracheostomy in severe traumaticbraininjury
Subacute sleep disturbance in moderate to severe traumaticbraininjury: a systematic review. Objective: This systematic review evaluated subacute sleep disturbance following moderate to severe traumaticbraininjury (TBI) and the impact of secondary factors such as mood or pain.Methods: A comprehensive search strategy was applied to nine databases. Inclusion criteria included: adults ≥18 years, moderate and severe TBI and within 3 months of injury. Eligible studies were critically appraised (...) with alterations of consciousness. Sleep disturbance tended to be particularly increased during the phase of post-traumatic amnesia (PTA) (78.7%).Conclusions: There is a limited amount of research available, which has inherent measurement and sample size limitations. The gold standard for measuring sleep (polysomnography) was rarely utilized, which may affect the detection of sleep disturbance and sleep architecture. Secondary factors potentially influencing sleep were generally not reported. Further
Update on the prevalence of persistent post-traumatic headache in adult civilian traumaticbraininjury: protocol for a systematic review and meta-analysis. Traumaticbraininjury (TBI) is a major public health concern. Persistent post-traumatic headache (PTH) is a common consequence of TBI affecting productivity and quality of life. The only review providing information about headache prevalence after TBI was published in 2008, combined data from civilian and military TBI, and was strictly
Melatonin as a Treatment after TraumaticBrainInjury: A Systematic Review and Meta-Analysis of the Pre-Clinical and Clinical Literature. Traumaticbraininjury (TBI) is common; however, effective treatments of the secondary braininjury are scarce. Melatonin is a potent, nonselective neuroprotective and anti-inflammatory agent that is showing promising results in neonatal braininjury. The aim of this study was to systematically evaluate the pre-clinical and clinical literature (...) . There was heterogeneity in the studies, and all had moderate-to-low risk of bias. Meta-analysis of pre-clinical data revealed an overall positive effect on neurobehavioural outcome with SMD of 1.51 (95% CI: 1.06-1.96). Melatonin treatment had a favorable effect on neurological status, by an SMD of 1.35 (95% CI: 0.83-1.88), and on cognition by an SMD of 1.16 (95% CI: 0.4-1.92). Melatonin decreased the size of the contusion by an SMD of 2.22 (95% CI: 0.8--3.59) and of cerebral edema by an SMD of 1.91 (95% CI: 1.08-2.74
Modeling sports-related mild traumaticbraininjury in animals-A systematic review. Sports-related head trauma has emerged as an important public health issue, as mild traumaticbraininjuries (mTBIs) may result in neurodegenerative disorders such as chronic traumatic encephalopathy (CTE). Research into mTBI and CTE pathophysiology are difficult to undertake in athletes, with observational trials and post-mortem analysis the current mainstays. Thus, animal models play an important role (...) in the study of mTBI, however, traditional animal models have focused on acute, severe injuries rather than the more typical mTBI's seen in sport injuries. Recently, a number of animal models have been developed that are both appropriately scaled and biomechanically relevant to the forces sustained by athletes. This review aimed to examine the literature for variables included in these animal models, and the resulting neurotrauma as evidenced by pathology and behavioral deficits. A systematic search
Efficacy of sertraline in post-traumaticbraininjury (post-TBI) depression and quality of life: A systematic review and meta-analysis of randomized controlled trials. The relative paucity of robust studies on pharmacological treatments for depression following traumaticbraininjury precludes establishment of firm recommendations for its routine use in this population. The purpose of this study is to determine the efficacy and tolerability of sertraline in the treatment of post-TBI depression
Tranexamic acid is safe to use following mild-to-moderate traumaticbraininjury. The studyThe CRASH-3 Trial Collaborators. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumaticbraininjury (CRASH-3): a randomised, placebo-controlled trial.Lancet 2019;394:1713-23.This trial was funded by NIHR Health Technology Assessment Programme (project number 14/190/01), JP Moulton Charitable Trust, Department of Health and Social (...) Care, Department for International Development, Global Challenges Research Fund, Medical Research Council, and the Wellcome Trust (Joint Global Health Trials scheme).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000870/tranexamic-acid-following-mild-to-moderate-traumatic-brain-injury-is-safe-and-reduces-deaths.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group
Handling of Missing Outcome Data in TraumaticBrainInjury Research: A Systematic Review. Traumaticbraininjury (TBI) research commonly measures long-term functional outcome, but studies often suffer from missing data as patients are lost to follow-up. This review assesses the extent and handling of missing outcome data in the TBI literature and provides a practical guide for future research. Relevant electronic databases were searched from January 1, 2012 to October 27, 2017 for TBI studies (...) that used the Glasgow Outcome Scale or Glasgow Outcome Scale-Extended (GOS/GOSE) as an outcome measure. Studies were screened and data extracted in line with Cochrane guidance. A total of 195 studies, 21 interventional, 174 observational, with 104,688 patients were included. Using the reported follow-up rates in a mixed model, on average 91% of patients were predicted to return to follow-up at 6 months post-injury, 84% at 1 year, and 69% at 2 years. However, 36% of studies provided insufficient
Prevalence of depression after moderate to severe traumaticbraininjury among adolescents and young adults: A systematic review. To review the prevalence of depression among adolescents and young adults after moderate to severe TBI. A systematic literature search was conducted on literature published up to December 2018 in PubMed, EMBASE, Cochrane and PsychInfo. A systematic review of the identified literature was based on PRISMA guidelines. Risk of Bias was evaluated based on the aspects
Association between Diffusion Tensor Imaging Findings and Cognitive Outcomes Following Mild TraumaticBrainInjury: A PRISMA-Compliant Meta-Analysis. Previous diffusion tensor imaging (DTI) research in mild traumaticbraininjury (mTBI) patients only concentrated on a limited number of brain regions and a specific cognitive function. Thus, the study aimed to explore the association between DTI findings and cognitive function following mTBI using a meta-analysis. We conducted a search
Intracranial pressure changes after mild traumaticbraininjury: a systematic review. Intracranial pressure (ICP) after mild traumaticbraininjury (mTBI) is poorly studied due to lack of sensitive non-invasive methods. The purpose of this review was to summarize the existing knowledge of changes in ICP after mTBI. Literature selection: PubMed, Embase, CINAHL, and Scopus were searched by three reviewers independently up to December 2016.animal and human studies measuring ICP and brain oedema (...) after an mTBI.moderate and severe forms of traumaticbraininjury, repeat samples, and studies that measured ICP at the time of impact but not after. Study quality was assessed using Downs and Black criteria.Of 1067 papers, 9 studies were included. In human studies, one provided direct evidence on increased, one provided indirect evidence of increased, and two provided indirect evidence of decreased ICP. In animal studies, three studies provided direct evidence of increased, one provided indirect
The Effects of Moderate-to-Severe TraumaticBrainInjury on Episodic Memory: a Meta-Analysis. Memory impairment following TraumaticBrainInjury (TBI) is among its most pronounced effects. The present meta-analysis focused only on studies of episodic memory (n = 73) conducted with adult patients with moderate-to-severe TBI. The results indicate that verbal Memory, and more specifically Verbal Recall, is most sensitive to the effects of moderate-to-severe TBI. Furthermore, verbal more than (...) visual memory and recall more than recognition are sensitive to the effects of TBI. These effects are more pronounced in delayed than in immediate testing. Several moderating factors were found: age at testing - the younger the age, the greater the effect size of verbal recall. A greater effect size of delayed story recall was related to an older age of testing and longer time since the injury. The higher the educational level, the smaller is the effect size of visual recall. The clinical
Overview of pharmacological interventions after traumaticbraininjuries: impact on selected outcomes. The purpose of this study was to conduct an overview of systematic reviews (SRs) to appraise the published evidence related to pharmacological interventions after traumaticbraininjury (TBI). Searches were conducted with Medline, Embase, PsycINFO, Web of Science, PubMed. 780 retrieved SRs underwent a two-level screening to determine inclusion. Data extracted included participant
Long-term employment outcomes following moderate to severe traumaticbraininjury: a systematic review and meta-analysis. Background: Returning to employment following moderate to severe traumaticbraininjury (msTBI) is critical for a survivor's well-being, yet currently there are no systematic reviews that comprehensively describe employment outcomes following msTBI. The objective of this study was to systematically synthesize literature on employment outcomes following msTBI.Methods (...) : Original studies published through April 2018 on MEDLINE/PubMed, PsychINFO, and CINAHL were eligible if the objective was to investigate employment outcomes following msTBI; outcome was measured ≥1 year; participants were ≥15; and size was ≥60. Post-injury employment prevalence and return to pre-injury level of work were summarized through meta-analysis.Results: Of 38 eligible studies, post-injury employment prevalence was most often reported (n = 35), followed by job stability (n = 6), and return
Pharmacological and non-pharmacological interventions of depression after traumaticbraininjury: A systematic review. Individuals with traumaticbraininjury (TBI) manifest a high incidence of depression, which is associated with an impaired recovery from TBI and a lower quality of life. Several neurobiological changes in patients with TBI contribute a form of depression that is unique to that of general depression. This is evinced by the poor efficacy of antidepressants in treating post-TBI
The Effectiveness of Virtual Reality Interventions for Improvement of Neurocognitive Performance After TraumaticBrainInjury: A Systematic Review. To evaluate current evidence for the effectiveness of virtual reality (VR) interventions in improving neurocognitive performance in individuals who have sustained a traumaticbraininjury (TBI).A systematic literature search across multiple databases (PubMed, EMBASE, Web of Science) for articles of relevance. Studies were evaluated according